【摘要】 目的 探讨血清白蛋白(ALB)、预后营养指数(PNI)和老年营养危险指数(GNRI)对老年口腔鳞状细胞癌(OSCC)患者预后的影响。方法 采用前瞻性随访研究的方法，收集2013年11月—2019年11月就诊于福建医科大学附属第一医院口腔颌面外科的OSCC患者477例，年龄≥60岁，均经病理确诊。采用Aplan-Meier法计算生存率，log-rank检验比较生存率差别，采用单因素和多因素Cox比例风险模型，分析ALB、PNI和GNRI对OSCC疾病特异生存率(DSS)的死亡风险比值(HR),评估术前营养状况对老年OSCC患者预后的影响。结果 本研究共观察19 604.8人月。营养指标ALB≥40.0 g/L、PNI≥35.71以及GNRI>98与老年术后OSCC患者预后呈负相关(HR:0.62,95%CI:0.40～0.97;HR:0.44,95%CI:0.27～0.80;HR:0.60,95%CI:0.37～0.97)。同时构建的Cox模型具有良好的预测性能(ALB:C-index=0.78,Somers’D=0.55,LRχ~2=65.51;PNI:C-index=0.78,Somers’D=0.56,LRχ~2=67.80;GNRI:C-index=0.78,Somers’D=0.55,LRχ~2=65.33)。结论 术前营养不良与老年OSCC患者不良预后相关，老年OSCC患者术前ALB、PNI、GNRI构建的预测模型有较好的预测性能，可用于临床改善老年OSCC患者预后。更多还原

【Abstract】 Objective To explore the effects of serum albumin(ALB), prognostic nutrition index(PNI) and nutritional risk index(GNRI) on the prognosis of elderly patients with oral squamous cell carcinoma(OSCC). Methods A total of 477 patients with pathologically confirmed OSCC were recruited from the First Affiliated Hospital of Fujian Medical University who were admitted from November 2013 to November 2019. The clinical and follow-up data of all the patients were collected by medical records and telephone interviews. Univariate and multivariate Cox proportional hazard models were used to compare the prognostic value of ALB, PNI and GNRI in OSCC disease specific survival(DSS). Results 19 604.8 people-month were observed. ALB≥40.0 g/L, PNI≥35.71 and GNRI>98 was negatively correlated with prognosis in elderly patients with postoperative OSCC(HR: 0.62,95%CI=0.40-0.97; HR=0.44, 95%CI=0.27-0.80; HR:0.60, 95%CI=0.37-0.97). Cox models had good prediction performance(ALB: C-index=0.78, Somers’ D=0.55, LRχ~2=65.51; PNI:C-index=0.78, Somers’ D=0.56, LRχ~2=67.80; GNRI: C-index=0.78, Somers’ D=0.55, LRχ~2=65.33). Conclusion ALB, PNI and GNRI have good predictive performance for the prognosis of OSCC in elderly patients.更多还原